BRIAN WILSON
Subscriber on policy B06M000822
Claims
1
Attributed to this person
Charged
372.00
Total submitted
Denied
372.00
1 denied claims
Patient responsibility
0.00
Reported on the 835
Patient responsibility is the amount reported on the 835 as assigned to the patient — deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.
Who this is
| Field | Value |
|---|---|
| Name | BRIAN WILSON |
| Role on the policy | Subscriber |
| Policy | B06M000822 |
| Date of birth | 16 Apr 2000 |
| Plan | BRONZE EPO |
| Covered from | 18 Apr 2024 |
| Covered to | open |
Patient responsibility reported on the 835
No patient responsibility reported on this person's remittances.
Care and denials
| Claim | Service | Charged | Payer | Outcome | Denied |
|---|---|---|---|---|---|
| CLM0003601 | 22 Dec 2025 | 372.00 | CASCADE CARE | CARC 27 · ELIGIBILITY | 372.00 |